Premature placental separation may increase child’s risk of heart disease in adult age, suggests study

The risk of developing early cardiovascular disease or dying from cardiovascular disease by the age of 28 was about 4.6 times higher among people born to mothers who had a placental abruption during their pregnancy. This finding was compared to people whose birth did not have this complication, according to new research published today in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.

Placental abruption occurs when the placenta separates from the uterus before birth rather than after delivery, and this can lead to severe hemorrhaging or other serious complications for the mother and baby. According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, most studies have reported an incidence of 0.5% to 1% for placental abruption in the general population.

“Our study suggests that placental abruption needs to be taken as a very serious complication for the mother and also potentially affecting the baby’s cardiovascular health later in life,” said study lead author Cande Ananth, Ph.D., M.P.H., chief of the division of epidemiology and biostatistics in the department of obstetrics, gynecology and reproductive sciences at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey. “Most treatments after a placental abruption focus on following the mother after a pregnancy complication. Our study shows it is important that their children are also monitored to identify potential complications due to their increased risk of cardiovascular disease. Having cardio-obstetrics working together with pediatric programs in medical schools and hospitals will be important to provide support and monitor the health of these mothers after delivery and their babies as they grow up.”

This study examined whether a mother’s placental abruption may be linked to the child’s risk of heart and stroke conditions and death from heart disease and stroke over about three decades.

The study reported that:

• Out of nearly 3 million pregnancies, approximately 1% (n = 28,641) were affected by placental abruption.
• During a 28-year follow-up period, children born to mothers who had a placental abruption during the pregnancy were 4.6 times more likely to die from cardiovascular disease than children born to mothers who experienced a normal placental separation from the uterus after delivery.
• Children born to mothers who had a placental abruption faced nearly three times higher risk of being hospitalized for heart-related complications during the next 28 years. These conditions included heart failure, ischemic heart disease, heart attack, blocked arteries and general cardiovascular disease.
• The children’s risk of stroke hospitalization was 2.4 times higher than for children whose mothers did not have a placental abruption.
• These heart disease and stroke risks associated with abruption were even higher among children younger than 1 year old.

The association between placental abruption and increased cardiovascular risk remained similar after conducting an additional analysis contrasting cardiovascular disease risks between biological siblings (each mother served as their own control), suggesting that genetic and environmental factors did not explain this relationship.

“Placental abruption is a sudden and often catastrophic event that cannot be prevented and comes with no warning. Older women or those expecting more than one baby, such as twins or triplets, have an increased risk of developing this condition. Health care professionals should support patients in maintaining a healthy lifestyle to protect their own health and their baby’s. Avoiding smoking, drinking alcohol and using illegal drugs (particularly, cocaine) and maintaining good blood pressure control are also important, as they are linked to placental abruption,” Ananth said.

“We know that women who have complications during pregnancy are often at higher risk for heart disease and stroke, and that’s why the American Heart Association recommends closely monitoring these women, especially in the first three months to a year after birth,” said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. “The findings of this study reinforce that it is also important to monitor their babies for risks and identify opportunities to reduce the potential impact these complications may have on them not only right after birth, but throughout their lifetime.” Rosen, who was not involved in this study, is also executive director of the Katz Institute for Women’s Health and senior vice president of women’s health at Northwell Health in New York City.

More research is needed to understand how placental abruption affects heart health in the children born from those pregnancies, according to the study authors. This study is among the first to find a link between cardiovascular risk in kids born to mothers with placental abruption. However, the findings are limited because the study is an analysis of hospital and death records; therefore, researchers cannot prove a cause-and-effect relationship.

Study details, background and design:

• This analysis is a study that looks back at past data. Researchers reviewed data from the Placental Abruption and Cardiovascular Event Risk (PACER) project, along with hospitalization and mortality records, to analyze roughly 3 million births in New Jersey from 1993 to 2020, focusing on mothers who had a placental abruption during pregnancy and the babies born to those pregnancies. This study focuses solely on single-baby births.
• Out of 2,949,992 pregnancies in the analysis, 1% (28,641 pregnancies) experienced placental abruption.
• The researchers followed the offspring for up to 28 years after their birth, reviewing hospital records and mortality records from the birth of the offspring to nonfatal cardiovascular-related hospitalization; birth to death from any cause; and nonfatal cardiovascular hospitalization to death from any cause.

Reference:

Cande V. Ananth, Emily B. Rosenfeld, Cardiovascular Disease in Singleton Offspring Born of Pregnancies Complicated by Placental Abruption: A Population‐Based Retrospective Cohort Study, Journal of the American Heart Association, https://doi.org/10.1161/JAHA.125.045199